One of the most distinctive traits of IE as a community and as a space of intellectual growth, is the opportunity to interact and learn from the exemplary leaders and practitioners in the field, from individuals who actually make and execute policies, projects and who have a unique and firsthand experience of not just what is happening in the world of business, politics, economics, but who often are the agents of change and innovation. So, it was truly a great opportunity and honor for the International Relations Club in association with the Africa Club to host Hon. Mahmoud Thabit Kombo, the Minister of Health of the Government of Zanzibar (Tanzania), who shared with us the challenges that the people of Zanzibar are facing in social development and what steps are being taken to tackle these issues.
We customarily treat Africa, and in particular countries from the Sub-Sharan region, as simply underdeveloped and lacking capacity and knowledge to grow and prosper. Often, for many people from the general public, the image of Africa doesn’t go beyond the UNICEF’s donations plea or the random new headline of another corrupt politician being installed in power. However, current socio-political and economic conditions in African countries are qualitatively more complex and sophisticated than that.
Indeed, Sub-Saharan Africa does face many severe problems that we are no longer used to in the West, none more than in the area of general healthcare. As Minister Mahmoud Thabit Kombo shared with us, an issue such as widespread access to potable water is unfortunately still a major challenge in Zanzibar. A large portion of the modest budget of this nation goes to ensure that all citizens have the capacity to satisfy basic need of clean water. Professional medical coverage is another fundamental challenge that Zanzibar is struggling with. For example, there is only one active radiologist for the whole archipelago! We are looking at a one to more than a million ratio. To put this into perspective, just one large hospital in Spain might have over 10 radiologists. As Hon. Mahmoud Thabit Kombo explained to the audience, the underlying reason for this disparity is twofold: on one hand, time and financial means needed to procure appropriate talent for the scale of the healthcare system in Zanzibar are often challenging to meet. Training a medical professional from the local population, which is ultimately a goal as well for the government, takes significant time and requires an input of relatively large investment and the benefits are only seen after many years. On the other hand, retaining these professionals once they trained, becomes even more challenging as the monetary incentive that the government of Zanzibar is able to offer is often not competitive comparing with job opportunities elsewhere. Thus, there talent exodus becomes a substantial impediment in improving the healthcare system. Finally, the simple issue of funding the budget of the ministry is still relevant. Unfortunately, the budget continues to be heavily dependent on the aid: about 40% of the funds come from international aid sources. This puts obvious restrains on the capacity of the government to act at their own will on the all the issues.
Despite all these issues, nonetheless, Zanzibar was able to embark on a number of successful and progressive reforms and policies that are reversing those negative trends. One of the biggest and truly meaningful achievements has been almost virtual eradication of malaria and AIDS in Zanzibar with less than 1% of the population being affected by these severe ailments. It is hard to underestimate the beneficial direct impact of this feat on the healthcare situation in Zanzibar but also indirectly on the whole social and economic development of the archipelago by liberating the people and the society at large from impediments related to these diseases. Furthermore, Zanzibar is in the course of profound re-building and re-shaping of the overall healthcare system with the concentration on primary, basic and prophylactics healthcare which has time and times again been proven to work very successfully in developing countries. There is a focus on extending coverage through educating the population on healthcare fundamentals such as for example family planning, additional built primary facilities and increasing the human talent dedicated to healthcare services. To further this goal the government is annually allocating 300 scholarships for university level studies including health related degrees that are expected, despite the previously mentioned talent drainage, to increase the professional base for the healthcare in particular and for the society in large at Zanzibar.
The most important aspect that was discussed by Mahmoud Thabit Kombo that is encompassing all of the mentioned above, was probably the fact that African countries and societies are fundamentally repositioning themselves within the international community and in the way how they approach international cooperation and internal challenges. Countries in region are moving more and more towards local emphasis and ground up approach to design and implementation of development solutions using local talent rather than simply consuming international given tools that often have very limited impact on the given local community due to low compatibility with native conditions and which often benefit foreign interest primarily. Thus, the programs that Zanzibar for example engages now are always filtered under internal priorities before they are being accepted for implementation. This is accompanied by a central change in international partnerships that African countries are engaging: when before Europe and in general the West have been the primary sources of international aid and support in Sub-Saharan Africa, contemporarily what used to be coined as South to South cooperation is becoming more and more prevalent. New giants such as China and India are becoming the chief partners of development efforts in many of the countries of the region, more and more replacing the role of the traditional Western influence. For example, China is increasingly investing in Zanzibar not only from a purely economic perspective, but is additionally actively sponsoring large healthcare projects as well, for example by donating 16 million dollars for a construction of a hospital in the archipelago. Furthermore, China is opening travel and study opportunities to African societies that are translating into changing attitudes in new generations towards what they see global centers. The challenge for Europe in this case as the Minister mentioned is that the lack of sufficient interest and involvement in Africa by Europe and West in general with increasing Chinese participation will significantly undermine the economic and political capabilities of the West in the region.
International Relations Club in association with the Africa Club would like to thank Jose Piquer, Executive Director, Undergraduate Studies in International Relations, IE School of International Relations, Campus Life team all the participant for making this event posible.
Alejandro Pereda Shulguin
International Relations Club